Lecture 1 Flashcards

Question

when is contact precautions recommended?

Answer 1

rec in patients with multi Rx resistant bacteria + enteric; parasitic or viral pathogen

Answer 2

Methicillin-resistant Staphylococcus aureus (MRSA) + vancomycin-resistant enterococci (VRE)+ C diff

Answer 3

In addition to standard precautions, use droplet precautions, or the equivalent, for a patient known or suspected to be infected with microorganisms transmitted by droplets (large-particle droplets [larger than 5 μm in size] that can be generated by the patient during coughing, sneezing, talking, or the performance of procedures). Bc droplets can remain suspended in the air for a limited amount of time, so exposure of <3ft is required for human to human transmition of droplet borne pathogens

Answer 4

Neisseria meningitidis + Pertussis + influenza + Adenovirus + Haemophilus influenzae B+ Mycoplasma + rubella + any other that is spread by droplet

Answer 5

face mask if you are about 6-10 ft away from that patient + room doors of these patients can remain open (unlike patients under airborne precautions)

Answer 6

In addition to standard precautions, use airborne precautions, or the equivalent, for patients known or suspected to be infected with microorganisms transmitted by airborne droplet nuclei (small-particle residue [5 μm or smaller in size] of evaporated droplets containing microorganisms that remain suspended in the air for a longer amount of time and that can be dispersed widely by air currents within a room or over a long distance).

Answer 7

TB + measles + varicella + small Pox + SARS (severe acute respiratory syndrome)

Answer 8

these patients need to be housed in a airborne infection isolation room which is a room with a negative pressure ventilation and it has at least 6-12 air exchanges/hour + room doors must remain closed in order to maintain that negative pressure+ must wear M95 respirator mask that you need to get specially fitted for-- it means that it has 95% filtering capacity

Answer 9

since the microbe can be transmited by dropplets or direct contact, BOTH contact and airborn precautions must be implamented in patients with SARS

Answer 10

Sterile technique is the method by which asepsis is maintained throughout the duration of an invasive procedure, thereby minimizing the introduction of microorganisms into a sterile field.

Answer 11

The primary goal is to provide an environment for the patient that promotes healing, prevents infections, and minimizes the length of recovery time.

Answer 12

All items used within a sterile field must be sterile +A sterile barrier that has been permeated must be considered contaminated + The edges of a sterile container are considered contaminated once the package is opened +Gowns are considered sterile in front from shoulder to waist level, and the sleeves are considered sterile to 2 inches above the elbow + Tables are sterile at table level only + Sterile persons and items touch only sterile areas; unsterile persons and items touch only unsterile areas + Movement within or around a sterile field must not contaminate the field + All items and areas of doubtful sterility are considered contaminated.

Answer 13

The goal of the surgical hand scrub is to remove dirt and debris and reduce the existing viable bacterial flora.

Answer 14

An ideal surgical hand scrub should provide the following antimicrobial effects: Immediate reduction in the resident bacterial flora Sustained effect to maintain a reduced bacterial count under surgical gloves Cumulative effect with each additional application of the antiseptic Persistent effect providing progressive reduction of bacteria with additional applications

Answer 15

1. Remove rings, watches, and bracelets before beginning the “surgical hand scrub” (i.e., a process to remove or destroy transient microorganisms and reduce resident flora).

Answer 16

2. Remove debris from underneath fingernails using a nail cleaner under running water.

Answer 17

3. “Surgical hand antisepsis” (i.e., a process for removal or destruction of transient microorganisms) using either an antimicrobial soap or an alcohol-based hand rub with persistent activity is recommended before donning sterile gloves when performing surgical procedures.

Answer 18

4. When performing surgical hand antisepsis using an antimicrobial soap, scrub hands and forearms for the length of time recommended by the manufacturer, usually 2 to 6 minutes. Long scrub times (e.g., 10 minutes) are not necessary.

Answer 19

5. When using an alcohol-based surgical hand scrub product with persistent activity, follow the manufacturer’s instructions. Before applying the alcohol solution, prewash hands and forearms with a nonantimicrobial soap and dry hands and forearms completely. After application of the alcohol-based product as recommended, allow hands and forearms to dry thoroughly before donning sterile gloves.

Answer 20

Chlorhexidine gluconate & povidone-iodine solutions, which are rapid-acting, broad-spectrum antimicrobials effective against gram-positive and gram-negative microorganisms.

Answer 21

Surgical Scrub: Timed method and Counted Stroke Method- Two methods of surgical scrubbing are typically used: the timed method, and the counted stroke method. Both methods follow a prescribed anatomical pattern of scrubbing, beginning with the fingernails, then moving on to the four surfaces of each finger, the palmar and dorsal surfaces of the hands and wrists, and extending up the arms to the elbows.

Answer 22

The timed method requires a total of 5 minutes of scrub time. The counted stroke method requires a specific number of bristle strokes for the fingers, hands, and arms. The scrub includes 30 strokes for the fingernails and 20 strokes to each surface of the fingers, hands, wrists, and arms to the elbows.

Answer 23

1. Organize supplies and adjust water to a comfortable temperature. 2. Wet hands and arms, prewash with soap from a dispenser, and rinse. 3. Remove the scrub brush from the package and use the nail cleaner to clean fingernails. 4. Squeeze the scrub brush under water to release soap from sponge. 5. With the scrub brush perpendicular to the fingers, begin to scrub all four sides of each finger with a back-and-forth motion. 6. Scrub dorsal and palmar surfaces of hand and wrist with a circular motion. 7. Starting at the wrist, scrub all four sides of the arm to the elbow. 8. Transfer the scrub brush to the other hand and repeat steps 5 through 7. 9. Discard the scrub brush and rinse hands and arms, starting with the fingertips and working toward the elbows. 10. Allow contaminated water to drip off the elbows by keeping hands above the waist.

Answer 24

in order not to contaninate yourself or your sterile field 1-hold your arms straight out, ALWAYS KEEP hand above waist- do not cross arms 2-The scrub nurse will place the gown on you 3-Circulating nurse ties the back of the gown 4- Give the scrub nurse the long string of your gown tie. Hold the other string yourself and turn around in place. Tie the strings

Answer 25

circulating nurse is the one that goes between the sterile and the non sterile fields

Answer 26

1. Nurse holds out right glove in palm toward you 2. Push your hand through the glove 3- repeat procedure with the left glove using 2 fingers of you gloved right hand to help hold the LEFT glove open

Answer 27

Preparing the Operative Site 1. Scrub the skin with the antiseptic solution, beginning at the procedure site and working outward in a circular fashion toward the periphery of the field (Figure 3-2). Make sure the area prepared is much wider than the procedure site. NOTE: The scrubbing action must be vigorous, including both mechanical and chemical cleansing of the skin. 2. On reaching the outer boundary, discard the first sponge and repeat the procedure until all prepared sponges are used. CAUTION: Do not return to a previously prepared area with a contaminated sponge.

Answer 28

Draping is the process of maintaining a sterile field around the procedure site by covering the surrounding areas and the patient with a barrier.

Answer 29

green/ blue/ gray- in order to decrease glare

Answer 30

1. Hold the drapes high enough to avoid touching unsterile areas. 2. Always walk around the table to drape the opposite side. CAUTION: Never reach over the patient. 3. Handle drapes as little as possible and avoid shaking out wrinkles (contaminants are present in the air). 4. When draping, make a cuff over the gloved hand to protect against touching an unsterile area and place the folded edge toward the incision. This provides a uniform outline of the surgical site and prevents instruments or sponges falling between layers. NOTE: Any part of the drape below waist or table level is considered unsterile. Towel clips fastened through the drapes have contaminated points and should be removed only if necessary. 5. If a hole is found in a drape after it is placed, cover it with a second drape. 6. Drapes should not be adjusted after placement. If a drape is placed improperly, either discard it or cover it with another drape.